title: Myocardial blood flow and infarct size after CD133+ cell injection in large myocardial infarction with good recanalization and poor reperfusion: results from a randomized controlled trial.
abstract: OBJECTIVE
  Large acute ST-elevation myocardial infarction (STEMI) sometimes leaves extensive ischemic damage despite timely and successful primary angioplasty. This clinical picture of good recanalization with incomplete reperfusion represents a good model to assess the reparative potential of locally administered cell therapy. Thus, we conducted a randomized controlled trial aimed at evaluating the effect of intracoronary administration of CD133 stem cells on myocardial blood flow and function in this setting.
  
  
  METHODS
  Fifteen patients with large anterior STEMI, myocardial blush grade 0-1 and more than 50% ST-elevation recovery after optimal coronary recanalization (TIMI 3 flow) with stenting were randomly assigned to receive CD133 cells from either bone marrow (group A) or peripheral blood (group B), or to stay on drug therapy alone (group C). The cells were intracoronary injected within 10-14 days of STEMI. Infarct-related myocardial blood flow (MBF) was evaluated by NH positron emission tomography 2-5 days before cell administration and after 1 year.
  
  
  RESULTS
  MBF increased in the infarct area from 0.419 (0.390-0.623) to 0.544 (0.371-0.729) ml/min per g in group A, decreased from 0.547 (0.505-0.683) to 0.295 (0.237-0.472) ml/min per g in group B and only slightly changed from 0.554 (0.413-0.662) to 0.491 (0.453-0.717) ml/min per g in group C (A vs. C: P = 0.023; B vs. C: P = 0.066). Left ventricular volume tended to increase more in groups B and C than in group A, ejection fraction and wall motion score index remained stable in the three groups.
  
  
  CONCLUSIONS
  These findings support the hypothesis that intracoronary administration of bone marrow-derived, but not peripheral blood-derived CD133 cells 10-14 days after STEMI may improve long-term perfusion.
authors.affiliation: Cardiology Department, Luigi Sacco Hospital, Milan, Italy. colombo_alessandro@hotmail.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Colombo
authors.forename: Massimo
authors.initials: M
authors.lastname: Castellani
authors.forename: Emanuela
authors.initials: E
authors.lastname: Piccaluga
authors.forename: Enrico
authors.initials: E
authors.lastname: Pusineri
authors.forename: Simone
authors.initials: S
authors.lastname: Palatresi
authors.forename: Virgilio
authors.initials: V
authors.lastname: Longari
authors.forename: Cristina
authors.initials: C
authors.lastname: Canzi
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Sacchi
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rossi
authors.forename: Roberto
authors.initials: R
authors.lastname: Rech
authors.forename: Paolo
authors.initials: P
authors.lastname: Gerundini
authors.forename: Maurizio
authors.initials: M
authors.lastname: Viecca
authors.forename: Giorgio Lambertenghi
authors.initials: GL
authors.lastname: Deliliers
authors.forename: Paolo
authors.initials: P
authors.lastname: Rebulla
authors.forename: Davide
authors.initials: D
authors.lastname: Soligo
authors.forename: Rosaria
authors.initials: R
authors.lastname: Giordano
mesh_terms: D000071916:AC133 Antigen; D000328:Adult; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D056988:Anterior Wall Myocardial Infarction / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery / Q000628:therapy*; D015703:Antigens, CD / Q000032:analysis*; D016026:Bone Marrow Transplantation; D003326:Coronary Circulation; D004452:Echocardiography; D005260:Female; D006023:Glycoproteins / Q000032:analysis*; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology*; D010455:Peptides / Q000032:analysis*; D036102:Peripheral Blood Stem Cell Transplantation; D049268:Positron-Emission Tomography; D020127:Recovery of Function; D013234:Stem Cells / Q000276:immunology*; D015607:Stents; D013318:Stroke Volume; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides